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A second-generation cementless hip prosthesis: improved results over the first-generation prosthesis

W S Tankersley1, M A Mont, D S Hungerford

  • 1Department of Joint Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

American Journal of Orthopedics (Belle Mead, N.J.)
|December 31, 1997
PubMed
Summary

The second-generation Porous Coated Anatomic (PCA) "E" series hip arthroplasty showed superior clinical outcomes and fewer revisions compared to the first-generation PCA prosthesis. This improved cementless hip implant design resulted in better patient results and reduced complications.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Materials Science

Background:

  • Cementless hip arthroplasty is a common procedure for hip joint replacement.
  • First-generation Porous Coated Anatomic (PCA) prostheses have been widely used.
  • Continuous innovation in implant design aims to improve patient outcomes and longevity.

Purpose of the Study:

  • To compare the clinical efficacy and radiographic outcomes of the second-generation PCA "E" series cementless hip arthroplasty with the first-generation PCA prosthesis.
  • To evaluate differences in revision rates and radiolucencies between the two implant generations.

Main Methods:

  • A retrospective matched-pair study comparing 42 patients with second-generation PCA "E" series implants and 42 patients with first-generation PCA implants.

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  • Patients were matched for age, sex, diagnosis, weight, functional status, and follow-up duration.
  • All surgeries performed by the same surgeons using identical approaches and rehabilitation protocols.
  • Minimum 5-year follow-up (60-76 months).

    • Main Results:

    • The "E" series group achieved significantly higher rates of good/excellent clinical results (98% vs. 81%, P=0.001) with a mean Harris hip score of 94 compared to 81 for the first-generation group.
    • Acetabular component revision rates were significantly lower in the "E" series group (2% vs. 19%, P=0.012).
    • Incidence of femoral radiolucencies was reduced in the "E" series group (19% vs. 50%, P=0.009), with "E" series radiolucencies being small, nonprogressive, and confined to zone I.

    Conclusions:

    • The second-generation PCA "E" series cementless hip arthroplasty demonstrates superior clinical performance and improved radiographic outcomes compared to the first-generation PCA prosthesis.
    • Design enhancements in the "E" series component likely contribute to the observed improvements, including reduced revision rates and lower incidence of femoral radiolucencies.
    • The findings support the use of the improved "E" series PCA prosthesis for cementless hip arthroplasty.